Open vs minimally invasive radical trachelectomy in early-stage cervical cancer: International Radical Trachelectomy Assessment Study

Salvo, Gloria; Ramírez, Pedro T.; Leitao, Mario M.; Cibula, David; Wu, Xiaohua; Falconer, Henrik; Persson, Jan; Perrotta, Myriam; Mosgaard, Berit Jul; Kucukmetin, Ali; Berlev, Igor; Rendón, Gabriel; Liu, Kaijiang; Vieira, Marcelo Andrade da Costa; Căpîlna, Mihai Emil; Fotopoulou, Christina; Baiocchi, Glauco; Kaidarova, Dilyara; Ribeiro, Reitan; Pedra-Nobre, Silvana; Kocián, Roman; Li, Xiaoqi; Li, Jin; Pálsdóttir, Kolbrún; Noll, Florencia; Rundle, Stuart; Ульрих, Е. А.; Hu, Zhijun; Gheorghe, M.D.; Saso, Srdjan; Bolatbekova, Raikhan; Tsunoda, Audrey Tieko; Pitcher, Brandelyn N.; Wu, Jimin; Urbauer, Diana L.; Pareja, René

doi:10.1016/j.ajog.2021.08.029

Cited by 25 publications

(16 citation statements)

References 12 publications

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“…Moreover, a meta‐analysis suggested the negative impact in recurrence for Stage Ib1 (HR 1.68, CI 95% 1.20–2.36) against MIS 28 . Regarding radical trachelectomy, the recently published IRTA study included 646 cases (358 open, 288 MIS) and did not find difference in the risk of recurrence at 4.5 years 29 …”

Section: Resultsmentioning

confidence: 99%

“…We believe that it reflects the persistent debate between experts on LACC trial 27 results and the best surgical approach for stages ≤Ib1, and also due to the recently published IRTA study. 29 Regarding the parametrial preservation topic, ConCerv study 24 was also recently published and we awaiting the final results of the other clinical trials. Additionally, only other three topics had <90% of agreement (fertility preservation in Stage Ib2, anti-stenosis device use, and uterine transposition).…”

Section: Discussionmentioning

confidence: 99%

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Brazilian Society of Surgical Oncology consensus on fertility‐sparing surgery for cervical cancer

Baiocchi

Tsunoda

Guitmann

et al. 2022

Journal of Surgical Oncology

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Objective Several controversies remain on conservative management of cervical cancer. Our aim was to develop a consensus recommendation on important and novel topics of fertility‐sparing treatment of cervical cancer. Methods The consensus was sponsored by the Brazilian Society of Surgical Oncology (BSSO) from March 2020 to September 2020 and included a multidisciplinary team of 55 specialists. A total of 21 questions were addressed and they were assigned to specialists' groups that reviewed the literature and drafted preliminary recommendations. Further, the coordinators evaluated the recommendations that were classified by the level of evidence, and finally, they were voted by all participants. Results The questions included controversial topics on tumor assessment, surgical treatment, and surveillance in conservative management of cervical cancer. The two topics with lower agreement rates were the role of minimally invasive approach in radical trachelectomy and parametrial preservation. Additionally, only three recommendations had <90% of agreement (fertility preservation in Stage Ib2, anti‐stenosis device, and uterine transposition). Conclusions As very few clinical trials have been developed in surgery for cervical cancer, most recommendations were supported by low levels of evidence. We addressed important and novel topics in conservative management of cervical cancer and our study may contribute to literature.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Brazilian Society of Surgical Oncology consensus on fertility‐sparing surgery for cervical cancer

Baiocchi

Tsunoda

Guitmann

et al. 2022

Journal of Surgical Oncology

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“…It is difficult to evaluate margin status and correlate this with the type of surgery as this information is often not available in the literature. The impact of the approach had been recently evaluated in an international retrospective study in stage IB1 disease (treated without neoadjuvant chemotherapy ) 20 . No deleterious effect of the use of a minimally invasive approach (laparoscopic ± robot-assisted) was observed compared with an open approach 20…”

Section: Dr Morice: What Are the Results Of Simple Cone/trachelectomy...mentioning

confidence: 99%

Neoadjuvant chemotherapy in fertility-sparing management of FIGO 2018 stage IB2 cervical cancer

Sanson

Zaccarini

Majer

et al. 2022

Int J Gynecol Cancer

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“…A remaining question is the oncologic safety of radical trachelectomy, whether performed openly or minimally invasively. The recently published IRTA study [67] retrospectively addressed this issue and evaluated 646 patients with early-stage tumor CC up to 2 cm in size for 4.5-year disease-free survival, overall survival, and recurrence rate. No difference was found when comparing the two groups for these three oncologic outcomes.…”

Section: Fertility Sparing-surgerymentioning

confidence: 99%

“…No difference was found when comparing the two groups for these three oncologic outcomes. However, the authors pointed out the limitations of the study-such as the retrospective nature and the low recurrence rates in the group of patients studied-and emphasized that further studies are needed [67].…”

Section: Fertility Sparing-surgerymentioning

confidence: 99%

Management of Early-Stage Cervical Cancer: A Literature Review

Guimarães

Godoy

Longatto‐Filho

et al. 2022

Cancers

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Cervical cancer (CC) remains a public health issue worldwide despite preventive measures. Surgical treatment in the early-stage CC has evolved during the last decades. Our aim was to review the advances in the literature and summarize the ongoing studies on this topic. To this end, we conducted a literature review through PubMed focusing on English-language articles on the surgical management of early-stage CC. The emergent topics considered here are the FIGO 2018 staging system update, conservative management with less radical procedures for selected patients, lymph node staging, fertility preservation, preferred surgical approach, management of tumors up to 2 cm, and prognosis. In terms of updating FIGO, we highlight the inclusion of lymph node status on staging and the possibility of imaging. Regarding the preferred surgical approach, we emphasize the LACC trial impact worldwide in favor of open surgery; however, we discuss the controversial application of this for tumors < 2 cm. In summary, all topics show a tendency to provide patients with tailored treatment that avoids morbidity while maintaining oncologic safety, which is already possible in high-income countries. We believe that efforts should focus on making this a reality for low-income countries as well.

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Open vs minimally invasive radical trachelectomy in early-stage cervical cancer: International Radical Trachelectomy Assessment Study

Cited by 25 publications

References 12 publications

Brazilian Society of Surgical Oncology consensus on fertility‐sparing surgery for cervical cancer

Brazilian Society of Surgical Oncology consensus on fertility‐sparing surgery for cervical cancer

Neoadjuvant chemotherapy in fertility-sparing management of FIGO 2018 stage IB2 cervical cancer

Management of Early-Stage Cervical Cancer: A Literature Review

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